Treating Couples Well

A Practical Guide to Collaborative Couple Therapy

David C. Treadway

• Publisher: Routledge
• Year: 2019
• ISBN:
  9781351847834
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Treating Couples Well shows clinicians how to create a collaborative approach to couple therapy, which will empower couples to take charge of their own treatment.

Written in an engaging and conversational style, the book carefully explains how to help couples choose between a variety of clinical approaches and offers effective treatment strategies for a wide range of issues, including infidelity, intimacy and sexuality, communication, mental illness, and addiction. Chapters also explore the importance of considering the therapist's own life experience and its impact on working with couples. Practical interventions, clinical vignettes, and homework exercises are included throughout to help therapists to successfully support the needs of each couple and to encourage meaningful work between sessions.

Drawing on a plethora of case examples from the career of a leading couple therapist, Treating Couples Well will be a valuable resource to couple and marriage and family therapists at all levels.

1

NORMAL CHALLENGES OF LONG-TERM RELATIONSHIPS

Robert looked like he was being drilled at the dentist office as Joan began our session with what was becoming a familiar litany of complaint.

“We spend all our time battling about whose turn it is to take time off from work to go to the kids’ parent-teacher conference, and who is doing the shopping. There’s never any time for an intimate, friendly conversation. And by the way, having a partner [she threw a darting look at Robert] forget to pick up his child after school is not exactly an aphrodisiac.”

“Hold on for a second, Joan,” I interrupted. “Unfortunately, you’re describing the modern American marriage, which turns out to be an endless round of business negotiations about who is doing what, when, where, and how. It’s kind of like the modern couple is now a small business with two CEOs. Not exactly a model that would pass muster at the Harvard Business School. And I’m sure that it’s frustrating for you, too, Robert.”

Robert looked at me and gave shrug of resignation. “Well, we don’t have very many Hallmark moments.”

“That’s part of our job here,” I said. “We need to find ways of separating out the grinding business of being a couple from the intimate, nurturing love making—and I’m not just talking about sex—of being a couple.”

And, for a moment, their heads nodded. Together.

Being a successful couple entails some really hard work. I help couples appreciate and accept the difficulties of being a long-term couple in this era when there is so much less institutional, community, religious, and familial support for the sanctity and institution of marriage. The challenges of being in a successful, committed relationship are more daunting than they’ve ever been.

This is a huge topic, and I will try to give you a kind CliffsNotes summary of some of the particular challenges that couples face in our post-modern society and some of the key qualities and healthy habits couples can develop that can increase their chances of creating stable relational well-being.

First, we are more individually isolated than ever before, often living far from family and friends, which leads to enormous increase of romantic/relational expectations of ourselves and our partners to meet a broad range our emotional needs. We’re not just supposed to be lovers, but also partners, best friends, and co-managers of our lives. Throughout most of human history, marital relationships were primarily an economic arrangement with very low expectations of either intense romantic attachment or intimacy. Now the expectation that somehow marriage should meet almost all of our emotional needs has crept into the culture.

Second, until approximately seventy years ago, gender defined the rules of engagement for almost all long-term relationships. Roles and power distributions were thoroughly defined as were methods for decision making and problem solving. Men and women spent the vast majority of their lives in the company of their same sex and not each other. Even sexuality was, for the most part, a protection racket: male sexual entitlement in exchange for physical and economic security.

Third, marriages usually were made within one’s own tribe or cultural group. Interpersonal styles, communication patterns, and normative behaviors were familiar to each partner and conformed to their expectations. Nowadays, individuals have much more ethnic, religious, and racial freedom in their marital choices. Each member might come from a sharply different culture with very idiosyncratic notions about what marriage should be like. Rarely are these expectations fully conscious much less negotiated by the couple as they set off into a shared life.

Fourth, in the past forty years, there has been a rapid increase of acknowledged and accepted diversity of sexual orientations and fluidity of gender identity. The increasingly broad acceptance of gay marriage, transgendered people, and gender questioning folks has transformed the definition of a “normal” marriage. Despite the ongoing, strong backlash, traditionally accepted norms of relational and sexual behavior are being expanded and redefined as the culture becomes more inclusive and accepting of diversity.

With all these changes in our post-feminist, multicultural, pluralistic era, virtually every aspect of being a couple (gay or straight) is a nonstop round of negotiation and frequently conflict. Couples have to negotiate and balance their careers, parenting, household chores, social and familial relationships, as well as intimacy and sexuality, all the while expecting each other to be their best friend. Having to create their own hierarchy, rules of engagement, role definitions, and, essentially, their own culture is a relentlessly draining activity. At the same time, societal expectations that each person be the source of nourishing almost all intimate and sexual needs creates a perfect storm for conflict and disappointment.

Given the modern high pressures of a committed relationship, the divorce rate of nearly 50 percent and the huge increase of people who have already survived their parents’ divorce, the question “Is our marriage good enough” often underlies the tensions and struggles couples go through. Couples come for treatment for a wide variety of idiosyncratic presenting problems, but the underlying question of whether their marriage is viable is often the core issue that hangs over many couples like the proverbial Sword of Damocles.

Common Obstacles Most Couples Face

Being a successful couple (again, gay or straight) is often like learning how to ride in a steeplechase. These are some of the difficult jumps to be mastered around the course.

Transitioning from Being “In Love” to Being “In Life”

Neuroscience has now revealed that the “in love” experience that has been idealized since the beginning of time in song, poetry, art, and music is similar to the heightened state of joy and euphoria created by drugs like cocaine and Ecstasy. The same parts of the brain are activated. Helen Fisher and other neuroscientists have shown that the heightened state of well-being created by hormonal flooding leads to the falling-in-love experience. This brain state is neither discriminating nor relationally attuned and has a natural shelf life of about eighteen months. However, it’s this short-lived but extremely powerful romantic attachment that draws people into lifelong commitments. Although this serves the need to perpetuate the species, it can be misleading for picking a life partner. I refer to it with my clients as “nature’s bait and switch.”

New couples may begin by opening their hearts and sharing whatever is on their minds, and they may feel known and loved more than ever before; they even feel unconditional love flowing between them. Then, suddenly, they discover that their partner has all the usual flaws and failings of normal humans. The honeymoon is over, and they are transitioning into a shared life. This is often when they first truly wound each other and begin to develop unsuccessful, dysfunctional ways of responding to those wounds.

New couples may begin to try learn how to give each other gentle critical feedback, like Charlie saying sweetly to James, “Honey, could you take a little bit more time with warming things up before going for the main event. I need to feel more connected before we do it.” And James replies with, “I thought you liked how assertive I can be.” Now they’re off to the races. Feeling misunderstood, Charles says, “I wasn’t being critical about your sexual techniques, I was just trying to share my own needs.” And James suddenly feels inadequate. Things can deteriorate quickly into who is feeling more criticized and/or who is overly sensitive.

Couples handle these tensions with all kinds of responses. It might become a debate, or they might lapse into silence; one member of the couple might take the blame and harbor resentment; they might try to “kiss and make up” while one or both of them are still stewing. These ways of handling hurt feelings that get started early in the life of the couple often become rigid patterns of interaction that get repeated for years before the couple ever comes into the office.

Although many couples “fall in love” before entering marriage and life commitments, others choose a life together without the romantic fireworks of the “in love” experience. They may get together because it’s the right time to settle down or because they’ve been too hurt by a prior relationship or they have an unplanned pregnancy. Even without the foundation of an intense romantic passion, they, too, go through a let-down effect as they transition from a good-enough intimate friendship into a committed life. One or both members often feel the pain of not having had the spark from the beginning. That too can lead to difficult patterns of interaction that mask an underlying disengagement and disappointment.

In addition to all the common issues of two individuals learning how to share a life and partner with each other, couples bring their childhood, hurts, disappointments, and yearnings, as well as expectations about what family life is like. Often, the intense challenges of growing up in a particular family—like being emotionally or sexually abused, or being a gay child in a culturally conservative family, or being a child of divorce or addiction—leave profound wounds. Most couples, as they create their own new, intimate relationships and families, hope to resolve and heal from their family-of-origin wounds.

In this first phase of a shared life, regardless of how the relationship began, it’s often impossible for couples to directly share their frustrations, let-downs, disappointments, and doubts with each other without hurting each other’s feelings. Each member of the couple tends to handle these feelings on their own, which can separate them at the deepest emotional level. Regardless of the presenting problem they bring to our offices, these underlying issues, developed in the beginning of the committed relationship, are still at the heart of the couple’s pain.

Almost all couples have a shadow of hurt, disappointment—even anger—within despite how successful they appear outwardly. I frequently make this point at workshops by playfully saying, “I may not be able to help every couple, but give me one hour with any couple, no matter how happy they say they are, and I can wreck their relationship.” Yes, more than a little provocative hyperbole there, but what I mean is that with focused questioning, I could expose the heartaches, hurts, difficult compromises, disappointments, and yearnings that one or both members of a couple have tucked away somewhere in their hearts. The quote “Men lead lives of quiet desperation” applies all too commonly to couples, too.

When Two Become Three

Becoming parents is both extraordinarily bonding for couples and potentially divisive. Obviously, the couple relationship loses a degree of primacy as the parents integrate an infant into their lives. Again, as when couples start down their path together, becoming pregnant and having a baby is idealized as a time of peak marital bliss. Yet the baby will come first from there on out, and couples’ adjustment to the change in their priorities is often difficult. Not only is their intimate life likely to be disrupted, but most of their nurturing, affectionate, loving behavior will be redirected to the infant instead of each other. Add in sleep deprivation, oftentimes two jobs, and the challenges of child care, and the couple relationship is pushed not only to the back burner, but usually off the stove entirely.

Couples usually make these adjustments without negotiation or complaint as they strive to become the best parents they can be. The precious, tender nature of welcoming a child into the world and the expectation that this is a wildly joyful event can inhibit sharing their doubts and disappointments about their experience of parenting with each other. So they each manage their difficult feelings alone. Difficult patterns of interaction often mask the underlying, unspoken tensions caused by all the changes couples must make. For example, “I think you are overanxious about the baby. All you do is worry about every little thing” can be code for “You are not paying any attention to me,” or “Why don’t you change her in the middle of the night and feed her a bottle, so I can get a good night’s sleep for once?” can also mean “I don’t feel like you’re there for me.”

The Long Leaving-Home Journey

After the onslaught of children, the next developmental stage for couples is the inevitable tension in the family around parenting adolescents and young adults. Today, the time of childhood innocence and purity has shrunk dramatically as early onset puberty, social media and TV culture, as well as peer pressures have accelerated kids’ development and their demands for autonomy and freedom. As described in the previous paragraph, parents adapt their couple relationship to the demands of early parenting. Then, when they face the new challenges of children’s demands for independence, as well as the underlying anticipation of the empty-nest syndrome, couples often hit a relational crisis. Parenting, particularly with oppositional kids experimenting with reckless behaviors, becomes much tougher if the couple doesn’t agree on how to find the best compromises and the right balance between being “tough” and being “loving.”

Any tensions about their own connection and intimacy issues that have been long deferred may underlie their battles about how best to manage the kids. A fight between a couple of parents that began as an argument simply about their teenager’s curfew might morph into a huge conflict about their lack of sexual intimacy, or alcohol abuse, or a suspicion of an affair.

This stage of a couple’s life also collides with the midlife crisis of the individuals in a way that further drives them into potential conflict, transgressions, and even doubts about the marriage going forward. Folks in their late forties and early fifties often privately wonder about the viability and quality of their relationship as they consider thirty-plus more years together without the unifying bond of keeping the family together. Given that divorce is a socially accepted alternative, couples often ask the question, “Is this marriage good enough?” In addition to crises triggered by affairs and substance abuse, this question is often at the core of what drives couple into therapy. And the harm of living in doubt about whether they should stay together, almost daily evaluating each other’s strengths and weaknesses is really corrosive and undermining to the couples’ relationship, somewhat akin to the impact of drinking battery acid.

Retirement and Aging

Another common crisis point in relationships comes in response to all the changes and renegotiations couples need to work through as they face retirement issues and inevitable aging and health challenges. A couple’s core structure and individual identity has been commonly organized around children and careers for decades. Letting go of both defining roles can rock couples profoundly as they adjust to changes in each other. I remember a wife saying to her newly retired husband, who had been a CEO of a Fortune 500 company, “Listen, George, if you tell me one more time how to load the dishwasher, after I’ve been doing the dishes for forty years, I’m walking out the door, and you can load them to your heart’s content!” A difficult power struggle ensued.

Virtually all aspects of the couple’s relationship, roles, expectations, shared vs. individual activities have to be renegotiated at this stage of their lives.

Each of these developmental stages is challenging and often the underlying cause that impels couples toward dysfunctional individual behavior and patterns of relating. By the time couples come for help, they may have made many, many attempts to repair and improve their relationship on their own. Usually one or both of them are in a crisis about whether the relationship can be sustained. That is why, in our first interviews, I usually try to reassure the couple by acknowledging the risks while pointing out the possibilities. “You know,” I say, “in Chinese the word ‘crisis’ is made up of two characters: Danger and Opportunity.”

Keys to Success in Long-Term Relationships

Each couple has to find their own path to a workable relationship or even a workable divorce. However, over the years I have found some positive attributes of relating that help couples work out relationships that thrive rather than just survive. None of us is t...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgments
• Introduction
• 1. Normal Challenges of Long-Term Relationships
• 2. Creating Collaborative Couple Therapy: First Interview
• 3. Effortful Love: Behavioral Change in the Here and Now
• 4. Homework That Works Well for My Clients
• 5. Behind Closed Doors: The Intimacy/Sexuality Conundrum
• 6. Camp Treadway
• 7. The Amends and Forgiveness Protocol
• 8. The Challenges of Infidelity
• 9. Working with Couples’ Family of Origin Issues
• 10. Divorce: The Sword of Damocles
• 11. When One Spouse Is the “Problem”
• 12. Mayhem, Moves, Mistakes, Mismatches
• 13. The Elephant in the Therapist’s Chair
• 14. The Therapeutic Use of Self-Disclosure
• 15. Our Calling
• Epilogue
• Appendix: Homework Handouts
• Bibliography
• Index